The heart of this study is a computer game version of catch which appears to involve four human players. When a player is thrown the ball, he must then throw it to another player of his choice. Every time a player receives the ball, he receives a bit of money.

In Andari et al. (in press), small groups of autistic and nonautistic adults ("P") individually play this game with three strangers ("A" "B" "C"). Much is done to persuade the autistic and nonautistic participants that the strangers, who in fact are elaborately programmed, are actual, present, proximate (in adjacent booths), decision-making human beings.

The three strangers start by equally distributing the ball to the other players. Then the elaborate program kicks in: A and C increasingly favour one player (P and B, respectively) while shunning the others. B's behaviour does not change.

In a prototypical display of us-vs-them thinking, the nonautistic Ps responded by ganging up with A to reap the social and monetary gains of a close alliance founded on the exclusion of half the players.

The autistic Ps in contrast displayed no such selfish and discriminatory behaviour. They continued to throw the ball to the other players in equal proportion, ignoring their self-interest in favour of keeping all players equally included.

Further, subjective ratings of the other players revealed that the autistic Ps did not have the kinds of biases that are routinely called hypocrisy. They did not judge C, who shared the most with B, as worse or less trustworthy than A, who shared the most with themselves.

According to Andari et al. (in press), autistics "cannot understand or engage in social situations," as evidenced by autistics' outstandingly altruistic performance in this game. It is this profound social deficit, this altruistic autistic behaviour, that was targeted for treatment.

And indeed, the treatment was successful. Autistics randomly administered a nasal mist containing oxytocin, rather than a saline placebo, significantly improved. They became willing to work with one of the players in an effort to shun and discriminate against the other two, and thereby get more than their fair share of money and attention. They became willing to see the player who shared with them as good and trustworthy, and the player who shared with someone else as bad and untrustworthy. They learned and displayed selfishness and hypocrisy and us-vs-them thinking. Their objectivity, fairness, and altruism were--temporarily--cured.

Then this finding was replicated in a second small group of autistic adults who performed the same task but without monetary rewards.

Success! Cue the avalanche of blogging and media stories. Uta Frith says, "This could be revolutionary."

There is more to Andari et al. (in press), which also reports on two tasks involving face images, about which a few quick notes:

1. There is little ecological evidence that autistics avoid face images or do not make eye contact with face images.

2. Numerous other studies (a few examples here, here, here, here) which feature stronger designs (e.g., use of fixation crosses) have found typical duration and distribution of visual fixations to human face images, and/or typical attention to the eye area, in autistics.

3. For the nonautistic participants, the reported total visual fixation time to the face images--the crucial measure--well exceeds the total exposure time (both tasks), which has me, for one, scratching my head.

4. As yet there is no evidence that the reported oxytocin-related measured changes in visual fixation times to face images would overall be more beneficial than harmful to autistics.

5. In other studies (examples here and here) faster saccades and shorter visual fixation times, presumed by Andari et al. (in press) to be a very bad thing, have been associated with enhanced performance in autistics.

All this too is telling in its way, but it cannot equal the reported spectacular findings with respect to autism and altruism. In this respect Andari et al. (in press), even with its obvious limitations in design, is an enormously valuable paper. It has much to reveal about how autistics are regarded, and about the nature and consequences of the fight against autism.

35 comments:

Very interesting take on the latest oxytocin spray research. I'd just written a short post on parent usage of the spray (homeopathic and real) on their autistic children last week before this new study hit the news. It's something I intend to look at more closely. It's not surprising that the self-proclaimed biomedical community touts this study as proof that they're on the right track, but it certainly on a superficial glance at it confirms that their conception of what makes good science and what is a sufficient sample to extrapolate out is woefully inadequate. But they were all about Wakefield's 13 (which they counted as 14) monkeys, too.

This is profound to me...the crux of the problem. It shows the shallowness of anti-autism in the way you have presented it. I'm not using the right words because I don't know them.

I have an anectdotal story. My son was attending red-cross swimming classes at a local WMCA. A group of people passed us, mostly Down Syndrome, and other forms of mental disabilities, enough to send any "normal" fourth grader into a tizzy.

"Do you see anything wrong with those people, Ben?" I asked, because seeing them with my eyes set up an instantaneous red flag,"not normal, not normal!".

"No." he said. And I'm pretty sure he just saw people. I always kind of admired him for that.

Thank you for bringing this to our attention. For live to have any meaning or reward, we have to be who we are.

I'm not sure how not being able to tell the difference between a person who is willing to work with you and a person who wants to take advantage of you is altruistic. Pro-social behavior is not necessarily altruistic. Being able to affiliate with people who have your best interests at heart is a pro-social behavior.

I would give just about anything if my adult autistic son could tell the difference between people who are really looking out for him and people who are just there to take advantage of him. He nearly died from at the hands of a "bully" he thought was his friend. That incident didn't stop him from associating with other vultures.

If they were to find and manufacture an oxytocin medication that would help my son learn how to socialize better, I'd encourage him to take it. It might actually save his life.

Also, I've never known my son or any of his autistic peers to be terrible altruistic.

If you have a neurological condition that causes you to engage in self-injurious behavior as has been written about you in the media and you don't believe that it does not need treatment that is your concern and no one else's. Though the reasoning of why a person who engages in self-injurious behavior and would not want treatment if a legit treatment existed is way too sophisticated for me to understand.

Though we disagree on a variety of topics, I agree with your point of view on the double standard between autistics needing treatment and bullies needing treatment. One of the proposed changes I would make in the DSM is to have bullying included as a psychiatric disorder. I would make bullying of autistics a crime and if an effective treatment existed for bullying I would favor a court orded mandate requiring treatment in order to avoid time in juvenile hall or to avoid charges. In the USA such court mandated treatments are called "diversions", one such example is court ordered drug rehab treatment for someone convicted of cocaine abuse, a felony, for example.

The boys who put my son in the hospital are now in prison as we speak. Each was given a chance to get out in 6 months if they accepted treatment, they did not. Now when they get out - at least the one who convinced my son he was a friend - will no doubt kill. I'm sure I'm first on his list.

I wasn't blaming my son for the incident. Obviously, I made sure the boys responsible paid for their crime. Most people are able to protect themselves from bad people by recognizing that they are bad. My son cannot tell the difference between people who want to help him and people who want to hurt him. You can try to make me out to be the closed minded evil person - but you would be wrong.

I read the article you wrote about. I followed the link you posted. You decided that what they found was altruism with no real justification for your position. Altruism is one of those silly little constructs that probably doesn't really exist. No one really intentionally does anything to benefit someone else. In some way, they get some kind of gain. Doing something for someone else because you don't know the rules of the social game doesn't qualify as altruism, it's naivety and gullibility.

There are some comments on Andari et al. (in press) from the Cambridge researcher Kate Plaisted Grant here, including:

"This recognition of difference, rather than illness or deficit, views autism as a way of thinking that allows greater understanding of certain aspects of the world than many neurotypicals are capable of, and that society benefits greatly from the contribution of these skills."

and @Cheri: actually, that view point (that "No one really intentionally does anything to benefit someone else.") is actually considered "deviant", and depending on how you have that influence your life and behavior, could result in a diagnosis of a personality disorder.

I know that I intentionally do things to benefit others, and I can only assume that others do as well. Do I do it to the extent that it creates a large deficit to myself? I say I don't, but I've had others say that I do, so perhaps that is a matter of perception.

I researched this topic for my blog. From what I could tell:1) It made subjects more relaxed so they could interact better but did not directly make them more sociable.2) The agent has a half life of 3-15 minutes and I was not convinced there was much carry over effect. Unless they are on continuous IV or sniffing it all day long, I am not optimistic it would work long enough to matter...Mike Montbriand MD painmuse.org

Hi Michelle, I have only just found your blog and have not read every one of your posts, so I may be commenting on something you have explained in previous posts...

I am a 44 yr old woman who was diagnosed with HFA/AS two years ago. This was after many years of difficulties with anxiety (including possibly inaccurate diagnoses of OCD, social anxiety, OCPD), sensory sensitivities (etc.). I have a PhD in the biomedical sciences.

I recently participated in a research study that used a Stroop test devised by Chris Ashwin [see: Ashwin C, Wheelwright S, Baron-Cohen S (2006). Attention bias to faces in Asperger syndrome: a pictorial emotion Stroop study. Psychological Medicine 36, 835–843.] My test responses revealed attentional biases to all faces (whether angry or neural) relative to neutral objects (a chair) - as was found by Ashwin et al. in men with AS. However, I was especially distracted by the angry faces, which definitely raised my anxiety levels during the task.

The researchers who administered this test asked me if I could explain how I felt when I look at human faces. (I have poor eye contact). I explained that I do find human faces distracting during a conversation - to the point that I lose my train of thought. Therefore, it is easier to just listen to what the person is saying. However, I also find eye contact provokes a lot of anxiety. It feels as if the person is staring right into the depths of my soul; beyond a boundary that feels comfortable.

You may have discussed eye contact and attention bias in a previous post on your blog, but I wondered if you could explain, as an academic with autism, why autistic individuals are distracted by human faces, and also why we can find eye contact difficult?

The published evidence with respect to how autistics view face images or videos is mixed.

If you look at all the available findings, you can't conclude that autistics as a group are unwilling or unable to attend to the eye area of human face images or videos. This in turn may or may not be informative as to what happens in real life.

Then there is the effect of cumulative experience--autistics and nonautistics may end up with very different kinds of social experiences.

My wild guess is that nonautistics are good at processing information--social and nonsocial--in similar, predictable ways (across time and across individuals). This in turn may have to do with nonautistics having, compared to autistics, more mandatory hierarchies of information processing.

Meanwhile autistics are likely to individually perceive aspects of social (and nonsocial) information that nonautistics "lose" to their efficient, similar, mandatory hierarchies of processing. This can result in overtly atypical autistic responses to various stimuli, which may in turn be misinterpreted. And so on.

In my opinion, Cheri is correct in saying that being unbiased in distributing the tossed ball, even to virtual players who don't reciprocate, is not definitively indicative of altruism. I have autism and I do believe in fairness and promoting equity in endeavors. Life, however, has shown me that sometimes I run into people who do believe in taking advantage of me. As far as the reason for those autistics who "played fair" in this video game? It could be that they were very obedient and believed in following the rules without question. I agree with you that the game-playing which the autistics presented is a virtuous character trait to possess. It is sad for me to see that this study endorses being greedy and self-serving as accepted & typical human traits, rather than base, animalistic behaviors. This study points out to me that the researchers began this study with the intent of re-forming autistics into more socially-accepted individuals. It is a great wish of mine that each person (whether autistic or not, wheelchair-bound or not, blind or sighted) be treated fairly, but I know that this has a scarce chance of happening. The cure for living in a world such as this is to be sure that I set effective boundaries regarding my personhood, my social circles, and my property. I cannot always recognize who is "safe" versus those who wish to take advantage of my gullibility. I do not like this, but such is my life. And for those autistic individuals who cannot realize that they have a need to set boundaries in order to protect themselves: they need agency which can provide physical protection or psychological protection or both.

In general a person who contributes more deserves more. I believe that as a matter of principle. To me this is a rule.

Our society doesn't teach that. They won't even include that in behavioral therapies, because such therapies unlike therapies to treat other learning problems are oriented in a more cosmetic direction rather than focusing on improving individual success.

It is not fair that social skills training ignores the so-called "nasty" social skills. Whether we like it or not these are also part of human nature, are used by NTs, and do impact an individual's success and consequently self-esteem and happiness. But I had to teach myself these things myself because I have AS.

Maybe I diverge on this and other things(I notice that I don't hold to the same rules many on the spectrum do), because justice is my special interest so I've analyzed concepts like this deeply and realized there is nothing morally wrong with reciprocity or with rewarding it. In fact it's an excellent social glue. The more reciprocity there is in the world the more we all benefit.

I think there are a lot of things we consider wrong which are not really wrong, because of what has been taught by society. There's been times I've deliberately committed faux pas for the greater good. When a social norm is outdated and having a harmful impact on society it is beneficial to the whole to violate it. This is called situationism, and was commonly practiced by activists in the 1960s.

Behavioral therapy should move beyond just teaching "how to get along" and teaching "how to be effective in asserting one's interests in social situations". "Social efficacy" should be center, "social acceptance" merely a factor that is considered with other factors in coming to "social efficacy".

Everyone on the autistic spectrum really should try oxytocin (or MDMA which is perhaps easier to acquire and affects oxytocin). The insights gained into nonautistic perpectives are worth more than any amount of discussion. If there was such a thing as anti-oxytocin so nonautistics could experience our point of view, the world would be a better place very quickly.

Any parents worried about autistics being taken advantage of because they aren't imprinted with the social hierarchy should note that oxytocin wouldn't help if it caused them to occupy a low rung on the hierarchy. If your kids got better at bullying people weaker than them they'd still be abused by those more powerful: oxytocin would help them rationalise the abuse, not remove it.

Note that nonautistics can't spot psychopathic manipulation - they have a blindness to parts of the hierarchy being fake. It's possible that oxytocin would have that blinding effect (I haven't tested this yet).

Do you really want to see people as rungs on a power ladder? It's instructive for a day but I could never live that way.

Also, if anyone remotely cares, I'm 80% sure that what Simon Baron-Cohen refers to as 'empathy', especially in his book about evil, is the in-group chauvinism promoted by oxytocin. If you've been around borderline personality disordereds and psychopaths (SBC's other 'zero empathy' people along with autistics) you'll have noticed they don't project the same scary vibe as most nonautistics - they're acting to fit into the hierarchy.

If true, it's a little worrying. Some may go to dangerous lengths to preserve their viewpoint as 'the correct one'.

In a prototypical display of us-vs-them thinking, the nonautistic Ps responded by ganging up with A to reap the social and monetary gains of a close alliance founded on the exclusion of half the players.

You can find the original paper here. If you look at the results, you'll see that the autistic players distributed the ball evenly, while the non-autistic players distributed it 1/2 to A, and 1/4 each to the other two.

So the game with autistic P looks like this:

A -> PB -> 1/3A, 1/3B, 1/3CC -> BP -> 1/3A, 1/3B, 1/3C

So the consequent possession of the ball looks like this:

A: 1/5B: 3/10C: 1/5P: 3/10

The game with non-autistic P looks like this:

A -> PB -> 1/3 A, 1/3 C, 1/3 PC -> BP -> 1/2 A, 1/4 B, 1/4 C

So the possession ends up looking like this:

A: 1/4B: 1/4C: 1/6P: 1/3

Notice that A and B now have the ball exactly fairly. P gets it more than C: essentially P is punishing C for never passing P the ball, without being unfair to A or B. I think this is perfectly reasonable fairness-enforcing behaviour.

Figure 1B is exactly my source, it shows "Healthy Subjects", by which they mean non-autistic, distributing balls quite close to a 1/2,1/4,1/4 distribution to the other players. This is certainly not "us-vs-them" collusion with player A.

Also from Andari et al (2010), basic information about how the ball was distributed by the programmed players (A, B, C):

"At game start, probabilities werehomogeneous for all players, that is, the participant had a probability P = 1/3 of receiving the ball from any of the three players. After a predetermined number of rounds, player profiles diverged such that player A (the “good” profile) sent, on average, 70% of its played balls to the participant (P), player B (the “neutral” profile) sent 30% of its played balls to P, and player C (the “bad” profile) sent 10% of its played balls to P."

As I wrote above, you can get more detailed information about the programmed players in the Supporting Information.